Provider Relations & Claims Advocate - Evernorth Behavioral Health - Remote

The Cigna Group

2d • $24 - $37 • Remote

About The Position

The job profile for this position is Case Management Analyst, which is a Band 2 Senior Contributor Career Track Role.
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Our people make all the difference in our success.
The Claims & PR Advocate is a phone queue-based position responsible for servicing inbound claim-related calls from members, providers, and provider office staff. Advocates will handle back-to-back calls throughout the day, with occasional outbound calls required to resolve claim issues. This role demands strong multitasking, technical proficiency, and independent problem-solving skills.
Note: This position requires a Bachelor’s degree to qualify.

Requirements

• Proven customer service experience
• Ability to thrive in a virtual team environment
• Strong interpersonal and communication skills
• Effective listening and organizational abilities
• Technical aptitude with multiple systems and applications
• Independent problem-solving and time management skills
• Proficient typing and PC skills
• Bachelor’s degree is required
• If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

Nice To Haves

• Prior experience in Evernorth Behavioral Care Specialist/Advocacy role preferred
• Experience handling behavioral health claims and provider relations calls is a plus

Responsibilities

• Answer inbound calls from members and providers regarding claims, contracting, and provider relations.
• Work in a structured call queue environment, handling a high volume of calls daily.
• Make outbound calls as needed for issue resolution or follow-up.
• Use multiple applications during calls to research and resolve inquiries.
• Call topics may include: Claim status inquiries and explanations
• Requests for claim reprocessing or adjustments
• Provider contract questions and demographic updates
• Authorization corrections to ensure proper claim payment
• Requests for duplicate EOBs or check reissuance
• Escalated issue handling via Advocate Handoff/Help Request (AHHR)
• Complaint submissions on behalf of members or providers
• Emailing resources and documentation to callers

Benefits

• Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
• We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level